What Are the Drivers Triggering Antimicrobial Resistance Emergence and Spread? Outlook from a One Health Perspective

Area of Science:

• Public Health
• Microbiology
• Environmental Science

Background:

• Antimicrobial resistance (AMR) is a critical global threat, causing nearly 5 million deaths and costing $730 billion annually.
• AMR exacerbates healthcare burdens and impacts agricultural productivity, posing significant economic challenges, especially in low- and middle-income countries.

Purpose of the Study:

• To review the mechanisms and drivers of antimicrobial resistance (AMR) development and spread.
• To analyze AMR through the integrated One Health framework, considering human, animal, and environmental health.

Main Methods:

• Synthesis of current research on AMR mechanisms and drivers.
• Analysis of intrinsic factors (resistance genes, mobile elements) and extrinsic drivers (environmental, socioeconomic, policy, climate).
• Examination of AMR spread via horizontal gene transfer and ecological pressures.

Main Results:

• Intrinsic factors like antimicrobial resistance genes (ARGs) and mobile genetic elements (MGEs) facilitate bacterial resistance mechanisms.
• Extrinsic drivers including environmental stressors, socioeconomic practices, and climate change accelerate AMR proliferation.
• AMR impacts human health, agriculture, food safety, and economies globally.

Conclusions:

• Integrated strategies under the One Health paradigm are essential to mitigate AMR transmission.
• Interdisciplinary collaboration, robust policy implementation (e.g., antimicrobial stewardship), and innovative technologies are crucial.
• Addressing AMR is vital for safeguarding global health and ensuring sustainable development.